Salvinelli 0312 EradiatingTBNearly nine million people — more than 2.7million of them living in the Muslim countries — become sick with tuberculosis each year, and nearly amillion and a half of these people die from the disease. Some 600,000 of those deaths occur in these countries, which represent almost 30 percent of global tuberculosis infections. Five Muslim countries — Afghanistan, Pakistan, Nigeria, Indonesia, and Bangladesh — are among the 22 nations classified by the World Health Organization as having the highest burden of tuberculosis.

For the developing countries in the Muslim world, tuberculosis represents both a humanitarian crisis and a limiting factor to growth. The disease mainly affects young adults who should be in their most productive years and shaping their countries’ futures. Tuberculosis is widely viewed as a disease of the poor, but it also affects individuals who earn higher incomes. Breadwinners who become ill with tuberculosis are often too sick to work for weeks or months. They and their families may even face financial catastrophe.

Thus, tuberculosis is challenging efforts bymany Muslim countries in Asia and the Middle East to improve the health and well-being of their citizens. A total of 1.6 billion people live in 57 countries that are members of the Organization of Islamic Cooperation, which is the largest group of Islamic nations in the world. Each year, a total of 2.7 million people living in these countries develop tuberculosis, and 600,000 people die from the disease, which accounts for almost 30 percent of global tuberculosis cases. Among the world’s top ten countries with the highest burden of tuberculosis, four are members of the Organization of Islamic Cooperation. These are Nigeria (5th in the world), Indonesia (5th), Pakistan (6th) and Bangladesh (7th).

Tuberculosis is a serious development problem for countries in the Muslim world because it is acting as a ratelimiting step to economic growth. Tuberculosis destroys families, damages economies, and keeps millions of people locked in the prison of poverty.

Drug resistant forms of tuberculosis, which are more difficult to diagnose and harder and more expensive to treat, are becoming a major concern in the Muslim world. An estimated 100,000 cases of drug-resistant tuberculosis occur in Muslim countries every year. Among the countries making up the World Health Organization Eastern Mediterranean Region, Afghanistan and Pakistan have a very high number of tuberculosis patients, and are among the world’s 22 countries with the highest burden of the disease. The region’s countries are working hard to expand tuberculosis care, but so far no country was able to eliminate the disease.

Archbishop Desmond Tutu once said, “tuberculosis is the child of poverty — and also its parent and provider.” Tuberculosis is a disease that disproportionately affects poor communities and worsens the conditions of poverty. It mostly affects individuals in the most economically productive years of their life. The World Health Organization and Stop TB Partnership reference studies that suggest tuberculosis patients, on average, lose three to four months of work time; as a result of a family member contracting tuberculosis, that family’s household income could decrease by 20 to 30 percent; and whenever a patient dies, the family loses about 15 years of income. Furthermore, at a social level, children whose parents become sick with tuberculosis are often pulled out of school in order to support the family. Tuberculosis creates a vicious cycle of poor people falling sick and remaining poor because of the devastating impact the disease has on their families and the economy of the community as a whole.

In light of these socio-economic factors, poverty eradication and economic development in the Muslim world will not be possible without addressing tuberculosis care in these vulnerable communities. We have good evidence that not addressing tuberculosis is more expensive than getting people treated. A 2009 World Bank research report showed that countries heavily burdened by tuberculosis could recoup 9 to 15 times their investments in tuberculosis control. For example, India — which has a heavy burden of tuberculosis but is striving to address it — can realize a return of $125 for every dollar invested in controlling the disease.

Therefore, to achieve the goal of sustainable development in Muslim countries as well as the rest of the world, there is a serious need for United Nations Member States from the Muslim world and beyond to proactively support tuberculosis eradication, urging the disease be prominently featured in the post-2015 agenda presently being discussed at the United Nations.

Tuberculosis is currently addressed under the Millennium Development Goal 6.c, which indicates the objective to halt and reverse the incidence of tuberculosis. It is undeniable that the inclusion of tuberculosis in Millennium Development Goals has put a previously largely neglected disease on the political agenda, holding governments accountable to stopping the spread of tuberculosis. Since, important progress has been achieved: 20 million lives were saved since 1995 and 51 million patients were cured across the world, and the annual incidence rates and total numbers of Tuberculosis patients are slowly declining.

There is a major risk that this progress will be neutralized or even reversed without enhanced political commitment on the issue of tuberculosis. The Millennium Development Goals will be updated in 2015, and the exclusion of tuberculosis in the post-2015 development agenda would be devastating because it would give political decision-makers a sign that tuberculosis doesn’t have to be taken seriously. For that reason, it is crucial that countries in the Muslim world and beyond advocate for tuberculosis eradication to be included as an important goal post-2015.

Tuberculosis has been a threat to mankind since 4000 BC. In all our history, we have never been as close to making tuberculosis a disease of the past as we are today. The impressive progress of tuberculosis control we have seen over the last five decades in the Americas and Europe shows that tuberculosis can be defeated with strong political commitment and adequate financial resources.

The United Nations, including its Muslim members, should urge world leaders to take responsibility and commit to the goal of eradicating tuberculosis. With the support of the Islamic Development Bank and the solidarity of rich countries of the Gulf, bold action could be taken. Ambitious targets on tuberculosis control in the post-2015 development agenda are crucial to support developing countries in overcoming poverty, fostering economic growth and saving lives.

The World Health Organization and Stop TB Partnership propose that the overarching goal of reaching “zero tuberculosis deaths and zero infections” be established in the new development agenda, and that ambitious milestones for 2020 are set to finally stop the epidemic across the world. Further emphasized is the importance of new emerging technologies, improved services, the quest for universal health coverage and social protection for all, which are strong factors that will allow these ambitious targets to be achieved.

I believe tuberculosis control has a crucial role to play in creating a better future — one in which countries are enabled to reach their development goals and no one has to fear the disease.